Incision and Drainage
Called an I & D, incision and drainage involves draining accumulated pus from an infected area through a surgically created incision. It’s indicated when an infection fails to resolve spontaneously. For example, in a furuncle or carbuncle, inflammation traps bacteria within a small, localized area. Because antibiotics can’t reach this area, an I & D is required to drain it.
The timing of an I & D is critical. If induration is just beginning, the I & D should be postponed to avoid the continued formation of pus postprocedurally. Until the I & D can be performed, the area should be treated with moist heat,
topical antibiotics, and gentle washing. The I & D can be performed after the pus consolidates.
topical antibiotics, and gentle washing. The I & D can be performed after the pus consolidates.
Procedure
The surgeon begins by anesthetizing the area. If the infected area is superficial and nearly ready to rupture, he may simply aspirate the pus with a needle and syringe. If the area is large, he may make an incision directly over the suppurative area, spreading its edges to allow drainage of pus.
After culturing the pus and allowing it to drain, the surgeon leaves the cavity open to promote healing. If the cavity is large, he may pack it with gauze to provide further drainage and to assist debridement. Finally, he applies a sterile dressing.
Complications
I & D is a minor surgical procedure with no serious complications. At worst, I & D may fail to relieve the infection.
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